Clinical Characteristics Of Wake-up Stroke And Shichen Exploration

Wake-up strokes(WUS) is the stroke occurring during sleep, There are no new cases of stroke symptoms, but after waking up, stroke are found by the patient or the witnesses. The exact time of stroke onset is obscured in WUS, Early treatment decisions were affected whether intravenous thrombolysis or endovascular therapy were used. According to previous reports, WUS patients are in the majority of the stroke population. Therefore, study on the characteristics of WUS, to investigate whether WUS could benefit from aggressive therapy, it is very meaningful.WUS is a natural exposure-terminate model of evidence-based medicine, because it’s early intervention and time delay, very suitable to investigate the early treatment of stroke, There are theory in TCM that the human body has a strong resistance and self-healing ability, The common treatment in TCM is to regulate the overall balance, to stimulate the body’s own potential, WUS is just the natural model to observe the disease undisturbed natural history and the rehabilitation of the human body ability. The time difference between WUS and non-WUS, can also be used to study the time medicine and the meridian theory of TCM.ObjectiveTo understand the clinical features of WUS, through the comparative study of "wake up" and "non-wake up" stroke, seek acute ischemic stroke early treatment decisions.MethodsAll data were came from the large database of encephalopathy Department of Guangdong Province Traditional Chinese Medical Hospital. Patients with acute ischemic cerebral infarction in 2012 were selected, who were arrived within 72h to the emergency department or encephalopathy department of our hospital. Baseline data, risk factors, laboratory examination, imaging examination, and the information related to time were collected.SPSS17.0 software was used for statistical analysis, normal distribution measurement data between the two groups by t test and multi group by single factor variance analysis; non normal distribution measurement data using the Wilcoxon rank sum test; count data occurrence rate or constituent ratio were compared using the chi square test.ResultsThere were 106 cases of acute ischemic stroke patients,36 WUS patients, accounted for 34%. Risk factors of WUS patients was less than that in non-WUS patients (P=0.005).The proportion of hyperuricemia of WUS patients are significantly lower than those of non-WUS patients (P<0.05), similar as fibrillation and diabetes. (P=0.056, P=0.062).There were no difference of gender, admission NIHSS score, laboratory examination.WUS patients within 3h,4.5h to hospital was significantly lower than that in non-WUS patients(P=0.043、P=0.007); The clinical severity of WUS are light, the sooner admission the better, non-WUS patients are on the contrary; non-WUS patients had more clinical severity than WUS when patients hospitalized within 24h.The peak incidence of WUS was 6:00-7:00 (Shichen Mao); NIHSS scores in 0～2h of Patients were significantly lower than those of 4:00～6:00,6:00～ 8:00, while the peak incidence of non-WUS was 14:00～18:00, NIHSS scores in shichen You were significant than shichen of chen (P=0.005、wei (P=0.006)、 shen 申 (P=0.005)、hai (P=0.017).The incidence of WUS and non-WUS have significant difference in different seasons, The clinical severity of WUS were Serious than those of non-WUS in summer while lighter than those of non-WUS in winter. ConclusionWUS has its unique clinical characteristics and Shichen. It is suggested that WUS and non-WUS may be different types of stroke, there exists different pathogenesis and disease course and that You shi and Mao shi are suitable treatment time in the viewpoint of TCM...